Treatment for Gynura segetum caused hepatic vein occlusive disease: a single-center retrospective study

Objective To explore the effects of different treatments on prognosis of patients with Gynura segetum caused hepatic vein occlusion disease (HVOD). Methods From July 2008 to January 2016, 85 patients with Gynura segetum caused HVOD were enrolled and received treatment of liver function protection and microcirculation improvement. According to different treatment options, patients were divided into non-anticoagulation group, non-anticoagulation transfered to transjugular intrahepatic portosystem stent-shunt (TIPS) group, anticoagulation group, anticoagulation transfered to TIPS group and anticoagulation-TIPS step-by-step treatment group. The efficacy of each group was observed. Chi-square test was performed for statistical analysis. Results Among 22 patients who received non-anticoagulation treatment, six (27.3%) patients were cured and 14(63.6%) patients died during the treatment period; besides two (9.1%) patients received TIPS because of ineffective treatment and achieved long-term survival. Among 63 patients treated with combination of low-molecular-weight heparin and warfarin, six (9.5%) patients died and 36(57.1%) patients were cured. The cure rate was higher than that of non-anticoagulation group (χ2=5.820, P=0.016). Other 21 patients received TIPS treatment, achieved long-term survival except one patient died from surgical complications. The cure rate of anticoagulation-TIPS step treatment group was 88.9% (56/63) which was higher than that of non-anticoagulation group, and the difference was statistically significant (χ2=31.350, P<0.01). Conclusions Compared to conventional liver function protection treatment and symptomatic treatment, anticoagulation therapy significantly increases the cure rate of patients with Gynura segetum caused HVOD. Anticoagulation-TIPS step-by-step treatment further improves the cure rate. Key words: Gynura segetum; Hepatic veno-occlusive disease; Heparin, low-molecular-weight; Warfarin; Portasystemic shunt, transjugular intrahepatic